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Alanna, I think you're probably right that it's insulin resistance. IIRC bariatric surgery patients usually aren't diabetic any more just hours after surgery, and you don't see the same effect in patients who are on diets or who are fasting for that time period. So it's something weird about removing that tissue and thereby modulating the signals that tissue is producing, I bet.

Okay, I'm totally grasping at straws here and possibly way off base, but could this have something to do with the fact that the women were larger (would that mean more blood? more stretched out vessels?) and then smaller? It could explain why the skinny exercisers may not have had the same benefit if they weren't bigger and then smaller...

Obese women who have bariatric surgery before getting pregnant are at significantly lower risk for developing dangerous hypertensive disorders during pregnancy than those who don't, according to a study of medical insurance records by Johns Hopkins experts...

The full text of the BMJ article is available [url="http://www.bmj.com/cgi/content/full/340/apr13_1/c1662?view=long&pmid=20388692"]here[/url] and says:

Almost 15% of women who delivered before surgery group had pre-eclampsia or eclampsia compared with about 3% of those who delivered after surgery (P<0.001) (table). Mild pre-eclampsia was the most common diagnosis and was less common among the deliveries after surgery than the deliveries before surgery (2.0% v 9.0%). There were also lower rates of both severe pre-eclampsia and eclampsia in the deliveries after surgery. Rates of gestational hypertension (13.0% v 2.5%, P<0.001) and chronic hypertension complicating pregnancy (13.8% v 5.4%, P<0.001) were higher in the women who delivered before surgery. Almost 12% of women who delivered before surgery had pre-eclampsia or eclampsia superimposed on pre-existing hypertension compared with only 1% of women who delivered after surgery (P<0.001)

which is pretty much made of awesome and win, especially if this retrospective data holds up in future studies.

Definitely talk to your doc about this if you're a candidate for weight loss. (And cue the comments from everyone who was a skinny exerciser and still got it.) :)

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